Pain medication and effects on recreational drugs and the brain

[Bruce]

There are a lot of warnings on using opioids with other substances.  The main warning seems to be the possibility of Serotonin Depletion Syndrome and either an increase of the substance or the opioids overpowering or changing the experian.  Either for the better or the worst.

 I see a lot of warnings saying "Just don't do it." because SDS may happen.  What are the odds? This reminds me of the scare tacktick of "Reefer Madness" propaganda.  What are the facts?  I am aware there is good medical proof that opioids DO have major impacts on a combination of different substances.  Not just short term or pretty effects.  but a chance to be depressed the rest of your life.   What happens if you are reliant on opioids (and other meds) to function?  

What are the effects and risks of different substances such as DMT and Ayahuasca , 2CI, LSD,  5-MeO-DMT, MDMA, Salvia delioriam, Karva, LSA also different cacti  with opioids and Lyrica.

Have there been any studies on the odds of getting Serotonin Depletion Syndrome?   I am aware there can be many factors to take in to count.  Even down to diet.  

How much of a risk is someone at if they do a combination of Pain management meds and recreation drugs?  Is it 50/50  or what?  Any studies?

Also any info on lyrica/ pregabalin  with the mention above?

 

Edited July 12, 2016 by Bruce

[-RC-]

I wouldn't necessarily classify 5-Meo or Ayahuasca as recreational. Certainly with tryptamines you will have significant engagement of the serotonergic system, but as to the impact on tryptamines and SDS I've got nothing. 

[endotheogen]

i know quite a few long term & dependant opioid users, that regularly use acid (every few weeks - every few months or microdosing regularly), dmt (weekly at times), cacti (every few months or micro dosing regularly) on occasion have used ayahuasca, all of this while on opiates. from these there have been no obvious negative effects from the outside - if anything the medicinal psychedelic use seems to uplift and call them froward and remind them of purpose outside of their opiate use. from my outside perspective mixing ketamine and opiates and ketamine and opiates and lyrica altogether has resulted in potential liver toxicity? nausea, sickness, fatigue etc.. hope that helps! 

i have a post up about pregabalin and opiate withdrawals, so out of interest - have you found it helps?

[Alchemica]

Serotonin depletion syndrome is a new term to me. If you hit the empathogens hard, you'll experience serotonin depletion and potentially (?) loss of serotonergic neurons but with other serotonergic susbstances, you'll mainly experience downregulation. For psychedelics (except DMT) tolerance rapidly sets in due to desensitization and internalization/downregulation of the 5-HT2A receptor.

 

For an interesting talk:

Medically, the main concern is serotonin syndrome which can occur by combining serotonergics - MAOIs and SSRIs/empathogens are classic examples but there are plenty of other risky combinations.

 

About the only combination I'd be concerned with is tramadol (perhaps  pethidine or methadone) with a MAOI or longer acting serotonergic. If you're on a classical opiate or opioid that doesn't impact serotonin, I don't see the issue. There is of course the risk for amplified respiratory depression combining an opioid with a sedative, and drug-drug interactions. If you want me to go into those, let me know what pain relief substance you're interested in.

 

You should be cautious when combining an MAOI with anything that boosts norepinephrine because this can raise blood pressure.

 

Don't take this as medical advice, I'm in a pretty cloudy headspace. Others can correct me as needed.

 

EDIT: As for combinations with pregabalin, I vaguely remember it may speculatively have some properties as a serotonin releasing agent at high doses but I can't see anything in the literature with regard to serious concerns. Once again, don't take this as medical advice.

Edited July 13, 2016 by Alchemica